Does My Child Need Speech Therapy?

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Most children go through periods of disfluency, or stuttering, while they are learning to speak. Disfluency refers to a hesitation, interruption or disruption in speech, which can be a normal developmental stage or a sign of a more significant problem. The key for parents and their medical providers is to distinguish between normal disfluency and a more significant stuttering problem that requires speech therapy.

Stuttering usually starts during periods of rapid language development; for instance, when a child is progressing from two-word phrases to speaking in sentences. This usually occurs between the ages of 2 and 5, but can happen as early as 18 months. Children may repeat sounds or words especially at the beginning of sentences, such as “I-I-I can’t.” When a child is tired, excited, upset or being rushed to speak, the problem is more noticeable. You may notice a child’s stuttering for several days or weeks, then not at all for a while, only to return again. A child is often unaware of his or her disfluency, although parents may be distressed by their child’s speech. Remain calm and accept that this is likely a normal developmental stage that passes.

Some children can have a persistent stuttering problem that can range from mild to severe. Those at risk for an ongoing stuttering may have a parent or family member who stutters. A child who stutters for longer than 6-12 months, has an onset of disfluency after age 3-and-a-half-years, or has a speech delay may be at risk for disfluency. Males are also at higher risk than females. Children with mild stuttering may have similar repetitions as those with normal disfluencies, but can have a higher number of repetitions overall and more repetitions per sentence, such as “Ca-ca-ca-ca-can I ha-ha-ha-have that?” They may also prolong sounds, such as “MMMMMMMommy, that’s mmmmmmmine.” Children with mild stuttering may be frustrated or embarrassed by their speech. Try not to have a significant reaction or comment on your child’s speech because this can make the child even more upset. It is best to stay relaxed and patiently listen. If the problem shows no signs of improvement after six to eight weeks, then speech therapy may be needed.

Children with mild stuttering that is not improving or those with severe stuttering should be referred to a speech-language pathologist for an evaluation. Treatment can include helping the child overcome the fear of stuttering and teaching the child to speak in a slower, more relaxed manner. In some instances, a speech-language pathologist can train parents to provide some therapy at home.

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Dr. Erin Stubbs is a board-certified Pediatrician at CMC Myers Park Pediatrics.